Abstract: A composite intraluminal prostheses for treating a stenotic region in a blood vessel. The intraluminal prostheses including a thermally expandable stent and an open cell stent cover where the cell size is selected to be small enough to prevent plaque prolapse and the ingrowth of diseased tissue through the openings in the stent, while allowing for the re-endothelialization of the blood vessel wall with healthy tissue. The stent cover is further able to expand and contract with the stent without becoming loose upon contraction and without exerting significant resistence to radial expansion.

Abstract: A pacifier is provided having two teat sucking portions integrally connected to a middle support member. Each of the teat sucking portion includes a shank portion and a nipple portion adapted to be sucked by the child. The support member may become either convex or concave depending upon the side of the pacifier in which suction is applied. The middle support member must have sufficient flexibility to allow this movement between neutral, convex and concave positions. The pacifier is made of elastomeric material such as natural or synthetic rubber. Preferably, air holes are provided in the center support section. These holes are preferably aligned horizontally and are aligned to the baby's mouth to facilitate airflow passage. The air holes also create more flexibility in the middle support member to allow movement between neutral, convex and concave positions.

Abstract: An expansible tunneling apparatus and associated methods for creating an anatomic working space for a surgical procedure. Various embodiments of one and two piece apparatus that permit laparoscopic observation both during tunneling and during subsequent balloon dissection are disclosed. In a disclosed one piece embodiment, a tubular member has a bore extending therethrough and an open distal end. A lip is formed in the distal end of the tubular member to capture the distal tip of a laparoscope that is inserted into the tubular member to permit observation of the procedure both during tunneling to a desired location and during subsequent balloon inflation. An elongated neck of the balloon is secured to the tunneling member. The elongated neck permits the tubular member to be withdrawn slightly from the balloon after inflation to facilitate observation.

Abstract: Apparatus and method for dilation of tissue utilize a tissue expansion device positioned on an inner cannula with an outer overlying expansive sheath that expands upon translation of the tissue expansion device therethrough. The tissue expansion device may be an olive or wedge formed near the tip of the cannula, and the expansible sheath includes two elongated shells that are fixably attached near proximal ends, and that are resiliently connected near distal ends. Translating the tissue expansion device through the expansible sheath expands the dimension of the shells to provide even dilation of surrounding tissue. Additionally, tissue dilation is performed in one continuous motion of retracting the inner cannula through the expansible sheath or pushing the tissue expansion device through the expansible sheath. The outer expansible sheath may be removed from the inner cannula to provide a dissection instrument having minimal outer diameter.

Abstract: An apparatus and method is provided for stenting bifurcated vessels. A proximal angled stent is configured for implanting in a side-branch vessel wherein the proximal angled stent has an angulated portion that corresponds to the angle formed by the intersection of the side-branch vessel and the main vessel so that all portions of the side-branch vessel at the bifurcation are covered by the proximal angled stent. A main-vessel stent is provided for implanting in the main vessel, wherein the main-vessel stent has an aperture or stent cell that aligns with the opening to the side-branch vessel to permit unobstructed blood flow between the main vessel and the side-branch vessel. Side-branch and main-vessel catheter assemblies are advanced over a pair of guide wires for delivering, appropriately orienting, and implanting the proximal angled stent and the apertured stent. In one embodiment, a stent delivery assembly is provided for implanting a Y-shaped stent in a bifurcated vessel.

Abstract: Fine structure stents physiologically acceptable to the body.

Abstract: An aneurysm embolization device which may be used to occlude a blood vessel or aneurysm. The device has a plurality of support struts which form a substantially ellipsoidal shape. The support struts are preferably formed from a nickel-titanium alloy, such as nitinol, which has superelastic characteristics. A mesh sleeve is disposed over the support struts. The mesh sleeve is preferably formed of a thrombogenic material, such as polyurethane, so as to encourage the formation of blood clots and scar tissue to permanently occlude the vessel.

Abstract: A hand-piece comprises an arm main body which moves relative to a grip section, and an arm section having a clamp member openable and closable with respect to a probe section. As a result of movement of the arm main body relative to the grip section, the clamp member is shifted between a closure position in which the clamp member cooperates with the probe section to hold living tissue between the clamp member and the probe section, and an open position in which the clamp member is separated from the probe section to release the living tissue.

Abstract: Forceps instrument comprising a sheath having a first end and an elongated maneuvering element slidably disposed in the first end of said sheath. The sheath has an axis. The instrument comprises two jaw-pieces, at least one of the jaw-pieces being movable away from and toward the other of the jaw-pieces when the maneuvering element slides axially in the first end of the sheath. The jaw-pieces have, in an extension of a part thereof, an arm extending progressively toward the axis of the sheath so as to form a first, internal, inclined surface extending progressively toward the axis and facing the latter and a second, external, inclined surface extending progressively toward the axis and facing the internal surface of the sheath. The arm has a convex excrescence which is slidable substantially against the internal surface of the sheath, the excrescence having a concave hollow cavity facing the axis.

Abstract: Treating a site within the body by, e.g., placing an endoprosthesis into the body, with a catheter having a proximal portion remaining outside the body and a shaft for positioning inside the body. The shaft includes in a distal portion a selectively expandable member which can be expanded from a small cross-sectional profile for receiving said endoprosthesis about said expandable member in a compact configuration and a large, expanded cross-sectional profile for expanding said prosthesis during placement into the body, and an elastic strip wrapped in helical fashion about said expandable member such that the strip is stretched when said expandable member is expanded to said large cross-sectional profile.

Abstract: Devices and methods for filtering blood. The devices generally comprise a mesh for filtering blood flowing within a blood vessel, particularly within an artery such as the aorta, a structure adapted to open and close the mesh within the blood vessel, and a means to actuate the structure. The methods generally include the steps of introducing a mesh into a blood vessel to entrap embolic material, and removing the mesh and the entrapped foreign matter from the blood vessel.

Abstract: A medical tubular-shaft instrument has an elongated tubular shaft, at least one movable tool at the distal end, furthermore at least one movable grip element at the proximal end, and lastly an elongated force transmitting element. A distal end of the force transmitting element is operatively connected to the at least one tool and a proximal end of the force transmitting element to the at least one movable grip element. The force transmitting element extends through the tubular shaft. The force transmitting element, at least in its region extending through the tubular shaft and at least locally, reaches radially at at least three circumferential points as far as an inner wall of the tubular shaft and between the three circumferential points has a clearance from the inner wall, and in its remaining segments extending through the tubular shaft has a clearance from the inner wall at least over part of its circumference.

Abstract: A probe is connected to a probe carrier that is positioned with respect to the body of a patient. The probe is moved into or out of the body incrementally by means of a driver mechanism and flexible coupler. The flexible coupler in one embodiment comprises a flexible sheath with a flexible driver shaft that can be passed within the flexible sheath and can be rotated or pushed forward and backward with respect to the sheath by a driver element thereby causing translational movement of probe. Several forms of probes, flexible coupling elements, and driver apparatus as well as methods of applications accommodate specific objectives.

Abstract: A catheter containing an inflatable balloon, which is at its periphery provided with hollow extensions that communicate between the outside of the balloon and the lumen of the catheter for use in the gene therapeutic treatment of local disorders by transfer of a desired gene to a target cell or tissue being part of or being located in the vicinity of a blood vessel. The catheter is preferably the Infiltrator® catheter.

Abstract: A stent has a body and a surface with at least a portion of the surface comprising metal with a coating thereon. The coating is selected from the group consisting of thiols and disulfides and combinations thereof. The thiols are of the form R—SH and the disulfide of the form R—S—S—R″ where R is an alkyl group and R″ is an alkyl group. The metal is selected from the group consisting of noble metals, silver and copper.

Abstract: A prosthesis for replacing or strengthening a particular part of the body is coated with a biodegradable, resorbable and biocompatible surface coating. Biologically active microspheres which controllably release the biologically active agents are embedded in the surface coating. The biologically active microspheres include encapsulated PGE1 in a polyethylene glycol mix, which over a period of time dissolves and releases the PGE1 into the body part.

Abstract: This invention relates generally to ultrasonic surgical apparatus. More particularly, this invention relates to an improved method and apparatus for generating profiled pulses of ultrasonic frequency vibratory energy at a distal surface of an ultrasonic applicator of an ultrasonic surgical instrument for application to tissues of a patient with specific relationships between a magnitude of the pulse of ultrasonic frequency vibratory energy and a duration of the pulse of ultrasonic frequency vibratory energy so that the ultrasonic applicator can be driven to vibratory amplitudes previously not achievable and a more expedient surgical effect obtained.

Abstract: A stent delivery system for delivering a self-expanding stent to a predetermined location in a vessel includes a catheter body having an axial guidewire lumen and a pull-wire lumen. A medical device such as a self-expanding stent is held in a reduced delivery configuration for insertion and transport through a body lumen to a predetermined site for deployment. The stent is carried axially around the catheter body near its distal end and held in its reduced configuration by a retractable outer sheath. A proximal retraction handle is connected to the proximal end of the catheter body and includes a pistol grip trigger engaging a rachet mechanism, which is connected to a pull-wire which extends through the pull-wire lumen and is connected to the retractable outer sheath.

Abstract: The invention is surgical instruments which facilitate substantially linear incisions, especially through the wall of vessels, such as arteries, which have been specifically designed for coronary artery bypass graft procedures (CABG) on the beating heart. The instruments of the invention are particularly useful to create the incision in the artery to which the bypass graft is sewed, typically the left anterior descending artery (LAD). The instruments of the invention allow incisions to be rapidly made, precisely measured, and cleanly formed so that a bypass graft can be rapidly sewn in place. In one embodiment, the invention is comprised of a hand-held instrument with a curved cutting edge formed on the interior edge of a curved or arcuitous segment located near the end of the instrument. The tip of the instrument has a point of penetrating the vessel wall. The point may have several alternate shapes to facilitate penetration of the vessel wall while maximizing the trauma to the surrounding tissue.

Abstract: One device in accordance with the present invention includes a surgical device for creating channels in tissue of a patient. The device includes a catheter defining a lumen and a transducer assembly carried by the catheter along a lengthwise dimension of the catheter. An end effector is operatively coupled to the transducer assembly and extends distally relative to the transducer assembly. The end effector has a vibrating channel-forming tip wherein the channel-forming tip is adapted to create channels in the heart of a patient. A method in accordance with the present invention includes the steps of inserting an end effector having a tip into a patient, placing the tip of the end effector in direct contact with a surface of the heart, energizing the end effector to cause the tip to vibrate, piercing through the surface of the heart with the tip to create a channel, and removing the end effector.